Name of Organization ____________________________________
Request Filed By _________________________________________
(Must be a Berkeley Heights resident 18 years or older)
Position in Organization___________________________________
Address_______________________________________________
Telephone_____________________________________________
Meeting Date(s)_________________________________________
Expected Attendance ____________________________________
Starting Time __________________________________________
Completion Time _______________________________________
Purpose of Meeting ______________________________________
Will Food Be Served? _____________________________________
Is A/V Equipment Needed?_________________________________
I have read the BHPL Meeting Room Policy and agree to abide by the rules and regulations contained therein.
Users agree to release the Free Public Library of Berkeley Heights, its officers, employees and agents from any and all liability for any and all claims that arise in connection with the use of the Meeting Room including, but not limited to, accidents, injuries or loss or damage to property.
Signature________________________________________Date________________
APPROVED_______ NOT APPROVED_____________ DATE____________
REASON NOT APPROVED:
Application adopted June 11, 2001